Public health programs are tasked with the collection of individual and population data from a variety of sources. Some examples of such data include, but are not limited to, birth records, immunization records, reportable diseases, laboratory reportable findings, syndromic surveillance feeds, and death records. This data may be used to identify, investigate, perform care coordination, evaluate care outcomes, and mitigate barriers to health.
In the US, the responsibilities of public health programs, as well as their data sources, are legislated at the state level. Consequently, there can be great variation from state to state (and even county to county within a state). Typically, public health programs are subject to voluntary or mandatory reporting requirements. In both cases, the programs are consistently limited by a lack of timely reports and significant under reporting. This level of performance may be due, in part, to the lack of incentives for compliance and/or the infrequency of consequences for non-compliance.
Becoming compliant can be very challenging. There is not a universal public health reporting implementation because each public health jurisdiction can have its own policies and report receiving capabilities. This non-uniformity among public health requirements in various jurisdictions significantly increases costs for compliance.
For the majority of data sources, conventional reporting involves manual completion of a public health paper form that is mailed or faxed to the appropriate program. A few states have created web portals for smaller reporting sources to enter their data. Unfortunately, there are potential problems with implementations that rely on current paper forms and web portals. One potential problem results from manually identifying the reportable activity, reportable locality, and the locality's policies. Another potential problem involves storing the forms or maintaining web links for accessing the forms. Another potential problem involves entering the data that may exist electronically in one format into another format corresponding to a program's proprietary system. These conventional implementations also can consume a lot of time and/or resources.
In some instances, larger reporting organizations have implemented custom electronic feeds. Unfortunately, there are also potential problems with custom electronic feeds. In some implementations, there is not enough public funding to maintain these interfaces. Also, a custom electronic feed may be limited in the ability to help the reporting needs of the majority of data sources. Also, a custom electronic feed likely will not cover the cases that need reporting to jurisdictions outside the state or local jurisdiction.